title: Risk factors for wound disruption following cesarean delivery.
abstract: OBJECTIVE
  Risk factors for post-cesarean wound infection, but not disruption, are well-described in the literature. The primary objective of this study was to identify risk factors for non-infectious post-cesarean wound disruption.
  
  
  METHODS
  Secondary analysis was conducted using data from a single-center randomized controlled trial of staple versus suture skin closure in women ≥24 weeks' gestation undergoing cesarean delivery. Wound disruption was defined as subcutaneous skin or fascial dehiscence excluding primary wound infections. Composite wound morbidity (disruption or infection) was examined as a secondary outcome. Patient demographics, medical co-morbidities, and intrapartum characteristics were evaluated as potential risk factors using multivariable logistic regression.
  
  
  RESULTS
  Of the 398 randomized patients, 340, including 26 with disruptions (7.6%) met inclusion criteria and were analyzed. After multivariable adjustments, African-American race (aOR 3.9, 95% CI 1.1-13.8) and staple - as opposed to suture - wound closure (aOR 5.4, 95% CI 1.8-16.1) remained significant risk factors for disruption; non-significant increases were observed for body mass index ≥30 (aOR 2.1, 95% CI 0.6-7.5), but not for diabetes mellitus (aOR 0.9, 95% CI 0.3-2.9). RESULTS for composite wound morbidity were similar.
  
  
  CONCLUSIONS
  Skin closure with staples, African-American race, and considering the relatively small sample size, potentially obesity are associated with increased risk of non-infectious post-cesarean wound disruption.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham , Birmingham, AL , USA.
authors.forename: Akila
authors.initials: A
authors.lastname: Subramaniam
authors.forename: Victoria C
authors.initials: VC
authors.lastname: Jauk
authors.forename: Dana
authors.initials: D
authors.lastname: Figueroa
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
authors.forename: John
authors.initials: J
authors.lastname: Owen
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects / Q000706:statistics & numerical data; D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000534:rehabilitation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013536:Suture Techniques / Q000009:adverse effects / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Cesarean; risk factors; wound disruption